Pathology of lung cancer

Question 1

common clinical presentations of lung tumours

Answer 1

grows silently, presents late, symptomatic- fatal

Question 2

causes of a localised opacity (coin lesion) on the chest xray

Answer 2

cancer, tuberculosis, cryptococcosis, aspergillosis

Question 3

types of lung carcinoma

Answer 3

small cell, NSCLC- squamous cell, adenocarninoma, large cell

Question 4

pathogenesis of primary lung cancer.

Answer 4

carcinogens have effect on epithelial cells in the lungs. make genomic changes in stem cells in lungs.

Question 5

how lung cancer spreads in central lung airways-

Answer 5

bronchial epithelial stem cells transform into invasive squamous cell carcinoma.

Question 6

inherited polymorphisms that make you predisposed to cancer

Answer 6

metabolism of procarcinogens, nicotine addiction

Question 7

local effects

Answer 7

haemoptosis, bronchial obstruction, pleural changes, nerves invaded, mediastinum, lymph nodes

Question 8

extrathoracic effects

Answer 8

liver, adrenals, bone, brain, skin, neural, vascular

Question 9

non metastatic effects

Answer 9

clubbing, hypertrophic pulmonary osteoarthropathy,

Question 10

prognosis in lung cancer

Answer 10

stage 3 and 4 incurable, only 10-12% of patients can get surgical treatment, small cell carcinoma is much more aggressive and has survival of 9 months on average

Question 11

how lung cancer spreads in in lung periphery-

Answer 11

bronchioalveolar epithelial stem cells transform into invasive adenocarcinoma

Question 12

small cell lung cancer cell type and distribution

Answer 12

neuroendocrine cells, central and early metastases

Question 13

non small cell lung cancer cell type and distribution

Answer 13

mucus secreting glandular cells and peripheral

Question 14

squamous cell lung cancer cell type and distribution

Answer 14

epithelial cells, central, local spread common but metastasises late

Question 15

adenocarcinoma lung cancer cell type and distribution

Answer 15

poorly differentiated, metastasises early

Question 16

large cell lung cancer cell type and distribution

Answer 16

neuroendocrine cells, central and early metastases

Question 17

common paraneoplastic hormones associated with small cell lung cancer

Answer 17

antidiuretic hormone ADH, Adrenocorticotophic hormone ACTH, Lambert-eaton syndrome

Question 18

common paraneoplastic hormones associated with squamous cell lung cancer

Answer 18

Parathyroid related protein PTHrP

Question 19

common sites for lung cancer to spread to

Answer 19

brain, bone, lymph nodes, liver, skin, adrenal glands